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Questions and Answers
Which cranial nerve is NOT responsible for the 8 cardinal fields of gaze?
Which cranial nerve is NOT responsible for the 8 cardinal fields of gaze?
What is the term for the ability of the pupil to change size in response to near and distant objects?
What is the term for the ability of the pupil to change size in response to near and distant objects?
A client has a visual acuity of 20/400. What does this mean?
A client has a visual acuity of 20/400. What does this mean?
While inspecting the eyelids, what term describes a localized collection of pus or infection on the eyelid?
While inspecting the eyelids, what term describes a localized collection of pus or infection on the eyelid?
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Which of the following is NOT a landmark of the tympanic membrane?
Which of the following is NOT a landmark of the tympanic membrane?
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Which term describes the involuntary, rapid, rhythmic movement of the eyes?
Which term describes the involuntary, rapid, rhythmic movement of the eyes?
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The Rhomberg test assesses which of the following?
The Rhomberg test assesses which of the following?
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What is the term for the white part of the eye?
What is the term for the white part of the eye?
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During visual field assessment, what is being evaluated?
During visual field assessment, what is being evaluated?
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Which cranial nerve is responsible for sense of smell?
Which cranial nerve is responsible for sense of smell?
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What is the term for the transparent layer covering the front of the eye?
What is the term for the transparent layer covering the front of the eye?
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When assessing the external nose, what should the examiner check for?
When assessing the external nose, what should the examiner check for?
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Which of these is NOT a part of the external structures of the eye?
Which of these is NOT a part of the external structures of the eye?
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Which of the following is NOT a step in the assessment of the mouth?
Which of the following is NOT a step in the assessment of the mouth?
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When assessing the tongue, which of the following is NOT a finding to note?
When assessing the tongue, which of the following is NOT a finding to note?
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During the palpation of lymph nodes, which of the following is NOT a characteristic to note?
During the palpation of lymph nodes, which of the following is NOT a characteristic to note?
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What is the correct order of palpation for lymph nodes in the head and neck?
What is the correct order of palpation for lymph nodes in the head and neck?
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Which of the following muscles is NOT assessed during the neck examination?
Which of the following muscles is NOT assessed during the neck examination?
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Which of these actions is NOT performed during the assessment of the neck?
Which of these actions is NOT performed during the assessment of the neck?
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Which of the following is NOT a finding to be noted when inspecting the hard palate?
Which of the following is NOT a finding to be noted when inspecting the hard palate?
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The assessment of the mouth includes all of the following EXCEPT:
The assessment of the mouth includes all of the following EXCEPT:
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When examining the trachea, the examiner should place their fingers on either end of the clavicle and bring their second finger down to the trachea. Where should the second finger fall?
When examining the trachea, the examiner should place their fingers on either end of the clavicle and bring their second finger down to the trachea. Where should the second finger fall?
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While examining the thyroid gland, what is the purpose of asking the client to sip on water?
While examining the thyroid gland, what is the purpose of asking the client to sip on water?
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When performing the posterior approach to palpate the thyroid gland, which hand is used to curve the fingers around the sternomastoid muscle?
When performing the posterior approach to palpate the thyroid gland, which hand is used to curve the fingers around the sternomastoid muscle?
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What is the most awkward approach to palpate the thyroid gland?
What is the most awkward approach to palpate the thyroid gland?
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What is a possible reason why lymph nodes are more easily palpated in children?
What is a possible reason why lymph nodes are more easily palpated in children?
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What is a possible reason why the thyroid gland may be palpable during pregnancy?
What is a possible reason why the thyroid gland may be palpable during pregnancy?
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In infants, the anterior fontanelle should be approximately how many centimeters in size?
In infants, the anterior fontanelle should be approximately how many centimeters in size?
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Which of the following conditions is NOT a possible finding in the examination of an elderly client?
Which of the following conditions is NOT a possible finding in the examination of an elderly client?
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Match the following eye structures with their corresponding descriptions:
Match the following eye structures with their corresponding descriptions:
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Match the following terms related to eye assessment with their definitions:
Match the following terms related to eye assessment with their definitions:
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Match the following cranial nerves with their respective functions related to eye movements:
Match the following cranial nerves with their respective functions related to eye movements:
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Match the following terms related to the inspection of the face with their descriptions:
Match the following terms related to the inspection of the face with their descriptions:
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Flashcards
Visual Acuity
Visual Acuity
Ability to distinguish images clearly, measured by a Snellen Chart.
Snellen Chart
Snellen Chart
A chart used to test visual acuity from a distance of 20 feet.
Tympanic Membrane
Tympanic Membrane
The eardrum, critical to hearing and assessed with an otoscope.
Auditory Acuity
Auditory Acuity
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Rhomberg Test
Rhomberg Test
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Trachea Examination
Trachea Examination
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Thyroid Gland Examination
Thyroid Gland Examination
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Posterior Approach to Thyroid
Posterior Approach to Thyroid
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Anterior Approach to Thyroid
Anterior Approach to Thyroid
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Infant Skull Assessment
Infant Skull Assessment
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Lymph Nodes in Children
Lymph Nodes in Children
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Thyroid in Pregnancy
Thyroid in Pregnancy
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Senile Tremors
Senile Tremors
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HEENT Anatomy
HEENT Anatomy
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Physical Assessment of Head
Physical Assessment of Head
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Facial Symmetry
Facial Symmetry
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PERRLA
PERRLA
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Eyeball Inspection
Eyeball Inspection
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Extraocular Movements
Extraocular Movements
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Visual Fields Test
Visual Fields Test
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Nystagmus
Nystagmus
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Mouth Inspection
Mouth Inspection
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Tongue Examination
Tongue Examination
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Palpate Lymph Nodes
Palpate Lymph Nodes
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Neck Mobility Testing
Neck Mobility Testing
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Lymph Node Locations
Lymph Node Locations
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Inspect Uvula
Inspect Uvula
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Buccal Mucosa Assessment
Buccal Mucosa Assessment
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Tongue Strength Test
Tongue Strength Test
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Assessment of the Head
Assessment of the Head
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Assessment of the Face
Assessment of the Face
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External Eye Structures
External Eye Structures
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Study Notes
HEA 1032 Health Assessment
- Course focuses on physical assessment of the head, face, eyes, ears, nose, mouth, and throat (HEENT).
- Presenter is Mrs. Keron Jones-Fraser, a PhD candidate, MSCN, BScN, and Certified Registered Nurse (RN).
Objectives
- Students will review briefly the anatomy and physiology of the HEENT.
- Students will describe the physical assessment of the head, face, eyes, ears, nose and mouth.
Motivational Activity
- Spot 5 differences in two identical images (likely cartoons).
Group Activity
- Groups will prepare presentations assessing assigned body systems (head & face, eye, ear, nose, mouth & throat, neck & regional lymph nodes).
- Presentations will include a short song, poem, or dub poetry.
- Time allocated: 30 minutes.
Assessment of the Head
- Physical Assessment:
- Inspect the head for size, shape, configuration, and involuntary movements.
- Palpate the head.
Assessment of the Face
- Physical Assessment:
- Inspect face symmetry, features, movement, expression, and skin condition.
Assessment of the Eye
- Anatomy: Diagram of the eye structure. (Diagram provided in the presentation) Includes labeled parts like sclera, cornea, iris, pupil, retina, optic nerve, etc.
- External Structures:
- Inspect eyelids for blinking ability, position (ptosis), and lesions (like stye).
- Inspect conjunctiva (color, lesions).
- Check sclera color (white, not red or yellow).
- Inspect cornea (opacity, scratches).
- Assess pupil size, shape, reaction to light and accommodation (use PERRLA, which means Pupils Equally Round Reactive to Light and Accommodation). Chart used for pupil size measurement (1-10mm).
- General Areas of Inquiry:
- Vision difficulty
- Pain
- Strabismus
- Redness/swelling
- Watering/discharge
- History of ocular problems
- Glaucoma
- Use of glasses/contacts
- Self-care behaviours
- Test pupillary reaction to light (room should be dim): look for direct and consensual pupillary response. Test accommodation (near and distance). Observe convergence and pupillary contraction.
- Extraocular movement: Evaluate eye movement with head remaining still (follow movement of object). Eight cardinal fields, controlled by cranial nerves 3, 4, and 6. Watch for nystagmus.
- Visual Fields: Assess peripheral vision.
- Visual Acuity: Determine the level of visual clarity (normal is 20/20, higher denominator indicates worse vision). Use a Snellen chart for testing.
- Internal Structures: Visualize the eye's fundus using an ophthalmoscope.
Assessment of the Ear
- Structure (Diagram provided): Outer ear (pinna, external auditory canal, tympanic membrane), middle ear (ossicles: malleus, incus, stapes), inner ear (cochlea, semicircular canals)
- Tympanic membrane landmarks: Identify handle and short process of the malleus, umbo, cone of light, pars flaccida, and pars tensa.
- Auricle: Assess position, symmetry, and presence of lesions.
- Canal: Inspect for drainage.
- Auditory acuity: Gross hearing assessment using voice response tests (test one ear at a time, covering the other. Start with whisper). Use two-syllable words like "baseball".
- Tuning fork tests: Tests like Weber and Rinne.
Assessment of the Nose & Sinuses
- External nose: Inspect for deviations in shape, size, color, flaring, and discharge. Check patency, and for sense of smell (olfactory nerve, CN I).
- Frontal/Maxillary sinuses: Palpate for tenderness.
Assessment of the Mouth
- Anatomy (diagram provided): Labels of various mouth and throat structures such as lips, teeth, gums, buccal mucosa (inside cheek), tongue, uvula, hard palate, soft palate, tonsils, etc.
- Physical Assessment:
- Inspect lips (color, consistency).
- Inspect teeth (number, color, condition, alignment).
- Inspect gums (color, consistency).
- Inspect buccal mucosa (color, consistency, Stenson's ducts).
- Inspect tongue (color, moisture, size, texture, fasciculations or tremors).
- Inspect hard and soft palate, uvula, and tonsils (color, size, exudate/lesions). Note any odor
- Check for Wharton's ducts.
Assessment of the Tongue
- Physical Assessment
- Check for midline protrusion.
- Inspect ventral surface and frenulum.
- Palpate lesions for induration (hardness).
- Inspect Wharton's ducts and sides of the tongue.
- Test tongue strength.
- Check anterior tongue (taste).
Neck & Regional Lymph Nodes
- General:
- Head should be held erect and still.
- Note enlargement of glands/pulsation of veins.
- Check for symmetrical muscle movement during active motion.
- Ask client to perform movements (chin to chest, touch ear to shoulder, touch chin to shoulder, etc.).
- Lymphatic Nodes: Use gentle circular motion to palpate nodes (preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical, deep cervical, supraclavicular). Note size, consistency, mobility, and tenderness. If enlarged or tender, assess area drained by the node.
- Trachea: Place fingers on trachea and evaluate symmetry.
- Thyroid gland (examination): Can be done from behind or in front of the client. It may not be palpable but note any possible swelling. Ask the patient to sip water, the thyroid should move in response.
- Posterior & Anterior approach: Described methods for thyroid check including: posterior, and anterior approaches.
Infants & Older Adults
- Infant skulls: Soft skull, head circumference typically larger than chest circumference. Note for any caput or cephalhematoma. Check front and back fontanelles (approximately 2.5 and 1 cm).
- Infant muscle development: Cradle the head and move it through the range of motion (ROM).
- Older adults: Lymph nodes easier to palpate in infants than elderly. Thyroid may be palpable in pregnancy. Senile tremors and increased curvature of cervical spine are possible findings.
References
- Weber, J., & Kelley, J. (2018). Health assessment in nursing. Lippincott, Williams & Wilkins.
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Description
This quiz covers key concepts related to the physical assessment of the head, face, eyes, ears, nose, mouth, and throat (HEENT). Students will review anatomy and physiology, describe assessment techniques, and engage in activities to reinforce their knowledge. Join in for an interactive experience with group presentations and fun activities.